Dural venous sinus cysts are rare, usually congenital lesions, most commonly observed as fluid-filled intraluminal lesions on cross-sectional imaging.
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Epidemiology
Dural venous sinus cysts are very rare, and are mostly congenital 1.
Pathology
Most dural venous sinus cysts are true fluid-filled lesions, only a small fraction are dermoid cysts 1.
Clinical presentation
Most dural venous sinus cysts are asymptomatic incidental findings. In rare cases they can cause dural sinus obstruction, leading to syncope or headaches 2.
Radiographic features
On non-contrast CT the cysts are typically hypodense, and fluid density can be demonstrated in larger ones. On MRI the cysts usually follow cerebrospinal fluid signal on all sequences. They do not enhance on CT/MRI 1.
Treatment and prognosis
Symptomatic cysts causing venous sinus occlusion may require surgical resection 2.
Differential diagnosis
- small volume pneumocephalus (aerocele), posing diagnostic challenge in a trauma context
- adipose tissue: shows fat density/signal
- arachnoid granulations: typically show a sessile or pedunculated structure
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